So much attention is paid to the problems in the trenches that it is easy to forget just how far we've come in the past few years. It was only 2008 when the oft-cited DesRoches NEJM survey showed that 4 percent of physicians had a clinically active electronic medical records system (my term for what they called fully functional EMRs). The following year, even an old-timer like me was surprised when a companion survey showed only 1.5 percent of hospitals had such a system.